Nutrition Clinic Consent

    Patient Telemedicine/Telehealth Consent and Disclaimer.

    I hereby attest that I am the parent or legal guardian of the patient or I am a patient who has attained the legal age of majority in Kenya and I have requested and authorized Gertrude's Garden Children's Hospital, Herein after referred to as “The Hospital” to arrange an online medical consultation (tele-consult) for me by a doctor who is a medical staff of the Hospital. Via this consult, the Hospital doctor will reach his or her conclusions regarding my medical diagnosis based solely on the information provided by me.

    To facilitate the Hospital’s doctor providing his or her opinion regarding my diagnosis, I authorize the doctor to use my medical history, pathology, laboratory and diagnostic results either available at the Hospital or from external sources. Gertrude's Garden Children's Hospital is authorized, at its election, to obtain any of such records and information.

    I understand and agree that:

    The Hospital’s tele-consult is solely based on the information provided by me and physician may not be aware of certain facts that may limit or affect his or her assessment or diagnosis of my condition and recommended treatment.

    The tele-consult is very different from a regular face-to-face examination and that the Hospital doctor providing the consult is limited by my input. Accordingly, the diagnosis I will receive is limited and provisional.

    Tele-consult is not intended to replace a full medical face-to-face evaluation by a doctor. Further, I confirm that I understand that the result of the tele-consult may be advise to visit a a medical facility if the clinical condition so dictates and that such a visit can result in additional cost.

    The Hospital doctor’s opinion and conclusions will be communicated directly to me so that an informed decision can be made for my medical needs.

    Medical information will be handled with strict confidentiality, privacy and security; however, I understand there are risks associated with any electronic transfer process from one location to another.

    I solely assume the risk of the limitations set forth herein, and I further understand that no warranty or guarantee has been made to me concerning any particular clinical result or outcome related to my condition or diagnosis.

    I commit to make full payment for this service should my financier refuse to settle the final bill for whatsoever reason and that I shall abide by the Hospital policies on billing and refund.


    I hereby completely and irrevocably release Gertrude's Garden Children's Hospital, its medical staff members, doctors and other health care professionals, insurance providers, administrators, officers, employees of any and all errors and omissions, known or unknown, foreseen or unforeseen, knowingly or unknowingly, as well as all claims, actions or damages arising from or in connection with the tele-consult.

    Furthermore, I agree that the Gertrude's Children's Hospital have no liability or responsibility for the accuracy or completeness of the medical information by myself or for any errors in the electronic transmission. As a condition to receiving the tele-consult service, I have read and acknowledge that I have given this consent of my own free will.

    By accepting and agreeing to these terms, I acknowledge and agree to assume the risks of the limitations set forth herein.